This study examines the relationship between health literacy as it applies to the workplace, i.e., "occupational health literacy," and work-related injury, which affects nearly 230,000 U.S. adolescents under 18 every year. Since general health literacy is known to be associated with a variety of health outcomes and with socioeconomic status (SES), occupational health literacy is likely to be related to occupational health outcomes and to SES as well, yet no studies have explored this hypothesis. In this study, we will examine occupational health literacy as both a determinant of work-related injury (WRI) prevalence and as a mediating factor in the known association between SES and adolescent WRI. Exploring this novel concept of occupational health literacy will forge new ground in understanding the causes of adolescent work injury and the association between SES and WRI among adolescents. Our specific aims are to determine, 1) if low occupational health literacy is associated with higher work-related injury prevalence among youth, 2) if youth of lower SES have lower occupational health literacy, and 3) if low occupational health literacy among low SES youth mediates the association between low SES and elevated work-related injury prevalence. We will achieve these aims by taking advantage of a unique dataset containing information on 2,315 adolescent workers of varying levels of SES in five cities across the US. These data include work-related injury prevalence, several measures of SES and an array of variables used to measure occupational health literacy (e.g., access to health and safety information and demonstrated health and safety knowledge and skills). This combination of data is rare and provides an excellent opportunity to answer the research questions posed in this study. The main analytic technique used in this study will be regression modeling. The high prevalence of WRI in this sample precludes the use of logistic regression. Therefore, Cox regression models will be used to obtain prevalence ratios as was done in the previous study of the association between WRI and SES. This study addresses traumatic injury and occupational health disparities among young workers, all of which are emphasized in the National Occupational Research Agenda. Study findings will be useful in developing interventions to enhance occupational health literacy among working youth, with specific efforts targeted at improving literacy among disadvantaged youth, to reduce their disproportionate injury burden. PUBLIC HEALTH RELEVANCE: This project investigates the role of "occupational health literacy" as both a determinant of work-related injury prevalence and as a mediating factor in the association between socioeconomic status and work-related injury among adolescents. Study findings will inform prevention efforts aimed at reducing the prevalence of adolescent work-related injury. They can also lead to intervention strategies that equalize occupational health literacy among youth, with specific efforts targeted at improving occupational health literacy among disadvantaged youth to reduce their disproportionate injury burden.